@layout("/common/_container.html",{bg:"bg-white",js:["/assets/modular/qrcode/qrcode_edit.js"]}){
<form id="qrcodeForm" lay-filter="qrcodeForm" class="layui-form model-form">
    <input name="id" type="hidden"/>
    <div class="layui-form-item">
        <label class="layui-form-label">编号<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="qrcode" name="qrcode" placeholder="请输入编号" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">二维码URL<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="url" name="url" placeholder="请输入二维码URL" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">备注<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="remark" name="remark" placeholder="请输入备注" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">代理商id<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="agentId" name="agentId" placeholder="请输入代理商id" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">扫码次数<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="scanNum" name="scanNum" placeholder="请输入扫码次数" type="text" class="layui-input" disabled />
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">状态<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input type="radio" name="recordStatus" value="1" title="使用"/>
            <input type="radio" name="recordStatus" value="0" title="禁用"/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">创建时间<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="createTime" name="createTime" placeholder="请输入创建时间" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">修改时间<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <input id="updateTime" name="updateTime" placeholder="请输入修改时间" type="text" class="layui-input" lay-verify="required" required/>
        </div>
    </div>
    <div class="layui-form-item text-right">
        <button class="layui-btn layui-btn-primary" type="button" ew-event="closeDialog">取消</button>
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>保存</button>
    </div>
</form>
@}